biloba, Citrus aurantium and Vaccinium) were identified in five patients. Due to the possible DIs, pharmaceutical recommendation was the withdrawal of the supplements or herbs, which were suspended in all cases. In one patient, possible Pglycoprotein DI was detected (Boswellia serrata), but removal was not considered necessary. Conclusion and Relevance Dietary supplements and/or herbs use in our population was lower than in other complex chronic patients. However, identification of possible DIs led to the withdrawal of the supplements and/or herbs in approximately one third of the patients.DIs with IVA/TEZ/ELX can have great clinical relevance and impact on health outcomes. Therefore, the review of concomitant treatments in the PC visit is essential to guarantee the effectiveness and safety of IVA/TEZ/ELX.
BackgroundThe use of STOPP/START criteria is part of the daily routine during pharmaceutical validation. One important pharmaceutical intervention is to recommend digoxin dose adjustment in elderly patients when it is prescribed 0.25 mg/day. Digoxin is a high risk medication; therefore, its correct use is important to prevent serious harm to patients.PurposeTo analyse the impact of pharmaceutical interventions related to digoxin dose adjustment in elderly patients.Material and methodsPharmaceutical interventions recorded between January and June 2015 in a university tertiary hospital were analysed. Recommendations regarding digoxin dose adjustment in patients aged over 75 years with 0.25 mg prescribed were selected. The following variables were measured: patient age, digoxin dose, dose reductions, intervention acceptance, changes in frequency of administration, digoxin substitutions and consequences of unchanged prescriptions.ResultsThere were 77 collected pharmaceutical interventions concerning digoxin dose adjustment in elderly patients. Average patient age was 86.2 (SD 5.7) years. After pharmacist recommendation, 63 (81.8%) prescriptions were modified: 53 (84.1%) suffered 50% dose reduction, 5 treatments were changed from daily to 5 or 6 days a week and 5 other treatments were substituted for carvedilol, bisoprolol or diltiazem. In relation to the 14 (18.1%) unchanged prescriptions, 12 had no negative consequences registered during the study period, but one digoxin prescription had to be reduced to 0.06 mg by the primary care physician and one last patient suffered digitalis toxicity.ConclusionPhysicians are increasingly conscious about the need for digoxin dose adjustment in elderly patients. This has been confirmed by the high rate of recommendation acceptance obtained. The fact that at least one case of digitalis toxicity occurred, reinforces the importance of applying this criterion.References and/or AcknowledgementsFilomena Paci J, García Alfaro M, et al. [Inappropriate prescribing in polymedicated patients over 64 years-old in primary care], Aten Primaria 2015;47:38-47 (Spanish)No conflict of interest.
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